Healthcare Provider Details

I. General information

NPI: 1730097908
Provider Name (Legal Business Name): JACKSON SCHMITS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MOORE ST STE B
BRISTOL VA
24201-4495
US

IV. Provider business mailing address

300 MOORE ST STE B
BRISTOL VA
24201-4495
US

V. Phone/Fax

Practice location:
  • Phone: 276-591-5448
  • Fax:
Mailing address:
  • Phone: 276-591-5448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104558201
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: